Insurance and Fees
I am an out of network provider and am not currently on any insurance panels. Most health plans offer out of network benefits and I am happy to assist you in determining what yours are.
I do offer a limited number of reduced fee slots based on financial need. If you are interested in being considered for a reduced fee slot, please let me know.
I take very seriously my commitment to make myself available for my clients and to meet their needs in scheduling appointments. From a business perspective, it is very expensive for me when I am unable to fill an open therapy slot. Therefore, I choose to have the following cancellation policy to protect my time, not to punish my clients. I require at least a full 24-hour period of notice if you plan to cancel, or you will be charged a $50 late-cancellation fee. You will be responsible for the full cost of the scheduled session in the case of no show.
Advantages of Self Pay
There are three reasons in my mind to consider self: A) Control of your protected health information (PHI,) B) Control over your course of treatment C) No record of psychiatric diagnosis in the Medical Information Bureau (MIB)
A) When a clinician submits a claim to an insurer for therapy, they must include a psychiatric diagnosis to justify medical necessity. If the clinician were to get audited by the insurer, they then must produce copies of office notes and documentation to insurer for review. Additionally, some insurers require clinicians to do utilization reviews after a certain number of sessions that include information such as prognosis, treatment plan, symptoms, diagnosis, and presenting problem. These items cannot be kept confidential when using your insurance for therapy.
B) In the utilization reviews mentioned above, insurers have the ability to dictate that clinicians are only authorized to see patients for a certain number of sessions per year, or determine the maximum length of time for a session to be. Many insurers are moving towards 30-45 minute therapy sessions, which may not be adequate to meet your needs. Lastly, in treatment for OCD and phobias, best practice requires that treatment occur in a setting to trigger anxiety. Many times this requires leaving the office setting, something that is not allowed by insurers if pursuing reimbursement.
C) When a health claim is a submitted to insurers, the diagnosis on said claim is submitted to your file within the Medical Information Bureau (MIB.) Providers are required to include diagnoses when submitting a claim to show medical necessity. Diagnoses within your file in the MIB are considered pre-existing conditions and could negatively affect your ability or rating currently or in the future when applying for life, health, disability, or long-term care insurance.
As with all things, it is prudent to weigh the benefits and the costs when making this decision.